Published on September 6, 2023
AHMEDABAD: Gujarat accounted for 17% of the 1,800-odd kidney transplants carried out in India in the past 12 years where the donor and recipient’s blood groups did not match. According to a recent study, 300-odd such transplants were held in Gujarat during this period.
The study on the ABO incompatible kidney transplant (ABOiKT) in India – the first for the country and having the largest cohort in the world – took into consideration 1,800-odd such transplants in India since 2011.
‘Acceptability of the kidney was better’ The results of such transplants are encouraging and indicate better acceptability than cadaver donations.
The findings were published recently in the journal ‘Transplantation,’ in the paper ‘A Multi-center Retrospective Cohort Study on Management Protocols and Clinical Outcomes After ABO-incompatible Kidney Transplantation in India.’
With a huge gap between demand and supply of kidneys in India, nephrologists are turning to live-donor matches where blood groups do not match. In such cases, the patients are given immunosuppressants and other medications to reduce the chances of rejection of the new kidney.
Dr Vivek Kute, professor of nephrology at IKDRC-ITS in the city and one of the lead authors of the study, said that the method is used when the patients are in dire need of transplant and conventional methods of live donor, donation from cadaver or cross exchange (living donors’ immediate relatives swap kidney donations) may take time.
“In the majority of cases, the results and acceptability of the kidney was better than the average kidney donation from cadaver donors,” he said. The study indicated a mortality rate of 9.5% as most of the deaths were due to infections. In other cases, too, the infection prevalence was about 17%.
Dr Umapati Hegde, a senior nephrologist at Muljibhai Patel Urology Hospital (MPUH) in Nadiad and another author of the study, said that the history of such transplants in India can be traced to the early 2000s. “In Gujarat, the first such procedure was carried out in 2013. But what has changed in the past decade is a better understanding of the phenomenon with pre-transplant procedures, medication, and after-transplant care,” he said.
He added that there is still a 5% difference in well-matched kidneys and ABOiKT. “But what we look at is about a 90% success rate that stops the patient’s need for regular dialysis. Experience indicates that such transplants have 10% better chances of long-term survival,” said Dr Hegde.
Dr Kute said that while well-matched kidney donation has been a norm, there has also been an emphasis on cross-matching to reduce the waiting period. “Gujarat has completed more than 500 such transplants. With the burden of kidney diseases on the rise, the need of the hour is to identify such methods where the patients can get timely organ donation to save lives,” he said.
Parth Shastri Archive 